Intussusception should visit which department?

Written by Bai Yan Hui
Pediatrics
Updated on February 09, 2025
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Intussusception generally falls under pediatric surgery, but many children arrive at the hospital without a clear self-diagnosis of intussusception; they often come due to abdominal pain. They can visit either the internal medicine department or the surgical department. At this point, the attending physician will conduct a thorough medical history inquiry, such as a standing abdominal radiograph, abdominal ultrasonography, and physical examination, to aid in diagnosis. If a diagnosis confirms the need for surgical intervention, whether it involves air enema or surgery, it is definitely within the scope of the surgical department.

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Written by Hu Qi Feng
Pediatrics
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Infant intussusception symptoms

Intussusception clinically presents with abdominal pain, which occurs in fits and starts and has a regular pattern. This manifests as sudden spasmodic colic; the child cries and is restless, drawing the knees up to the belly and turning pale. The pain lasts for several minutes or longer, then eases off, allowing the child to fall asleep quietly. These episodes recur every 10 to 20 minutes as intestinal movements provoke further attacks. Vomiting occurs, initially consisting of curdled milk or food residues and later containing bile-stained, feculent fluid. Moreover, blood in stools is an important symptom. Symptomatically, stools may appear normal for a few hours, but within six to twelve hours, 85% of affected children might pass jelly-like mucus blood stools. A palpable lump can be detected in the upper right abdomen, indicative of the point of intussusception. As for general symptoms, the child may appear well early on, but as the condition worsens, intestinal necrosis or peritonitis may occur, leading to severe dehydration, high fever, lethargy, coma, shock, and other signs of systemic toxicity.

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Does infant intussusception require surgery?

Intussusception lasting between forty-eight and seventy-two hours, or if the duration is shorter but the condition is severe, including cases with intestinal necrosis or perforation, as well as those involving small intestine type intussusception, all require surgical treatment. Depending on the overall condition of the child and the pathological changes in the intussuscepted bowel, options include reduction of intussusception, intestinal resection and anastomosis, or enterostomy, etc.

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Can pediatric intussusception be cured?

Once intussusception occurs, only a small portion of the small intestinal intussusception can reduce on its own. Those occurring in the colon or where re-intussusception occurs generally cannot reduce spontaneously and require enema therapy or surgical treatment. Enema therapy refers to cases where the intussusception occurs within forty-eight hours, the overall condition is good, there is no abdominal distension, no obvious dehydration or electrolyte disorders, and air or barium enema can be used. If the condition persists for more than forty-eight hours, the overall condition is poor, with symptoms such as dehydration, lethargy, high fever, shock, significant abdominal distension, signs of peritoneal irritation, multiple occurrences of intussusception, prior organic changes, or situations requiring surgical treatment for small bowel intussusception.

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Is intussusception in children serious?

Intussusception is a life-threatening emergency, and its reduction is an urgent medical treatment that must be performed immediately once diagnosed. Generally, in the early stages of intussusception, the general condition is still good, with normal body temperature and no symptoms of systemic toxicity. As time progresses, the condition worsens, and there may be necrosis of the intestines or peritonitis, with overall health deteriorating. Common severe symptoms include dehydration, high fever, lethargy, coma, and shock from toxicity.

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Why does intussusception cause bloody stool?

Once intussusception occurs, only a small portion of the small intestine intussusceptions can reset themselves. Due to the continuous spasm of the sheathed intestinal tract, microcirculatory disorders occur in the intussuscepted segment. Initially, venous blood flow is obstructed, leading to tissue congestion and edema, venous varicosity, and mucosal cells secrete a large amount of mucus into the intestinal lumen, which mixes with blood and feces to form a jam-like jelly substance that is expelled. The intestinal wall becomes edematous, and the obstruction of venous return worsens, affecting the arteries, resulting in insufficient blood supply, and leading to systemic toxic symptoms. In severe cases, intestinal perforation and peritonitis can occur.